Clinical relevance of serum amyloid A protein monitoring in urinary tract infections.

We have evaluated the clinical relevance of monitoring acute phase proteins in severe urinary tract infection. Body temperature, white blood cell count, erythrocyte sedimentation rate, serum amyloid A protein (SAA), C-reactive protein (CRP), alpha-1-antichymotrypsin (ACT) and alpha-1-acid glycoprotein (AGP) were determined daily in sera from 18 treated patients. Two patterns of response could be identified: responders and non-responders whose therapy had to be changed. Mean values for each acute phase protein were calculated daily in both responders and non-responders. Statistical evaluation of the significance between the means for each protein was also performed on a daily basis and showed P < 0.01 for SAA and CRP on day 3, for ACT on day 5, and for AGP on day 6. SAA and CRP appear to be the most reliable markers for antimicrobial therapy monitoring in patients with urinary tract infections.

Serum amyloid A protein in patients with acute myocardial infarction.

The concentrations of four acute phase proteins were measured in sera of 40 patients with acute myocardial infarction (AMI) to evaluate their behaviour from day-to-day and to find out if they can serve for early prediction of postinfarction complications and mortality rate. Peak levels of serum amyloid A protein (SAA) were increased up to 5000-fold above the normal value and those of C-reactive protein (CRP) about 100-fold, 3 days after AMI. alpha 1-antichymotrypsin (ACT) and alpha 1-acid glycoprotein (AGP) peak levels were increased up to eightfold above their normal values. Patients who developed postinfarction complications had significantly higher SAA values on admission than those without complications (mean values of 379 and 45 mg/L, respectively; P < 0.0001). Using a level of 100 mg/L on admission as a reference value gave a reasonable sensitivity and predictive value for complications (73%) and a very good sensitivity (80%) for early prediction of fatal outcome. Patients with SAA values above this limit had double the risk of complications and four times the risk of a fatal outcome. The correlation with CRP values was lower than it was with SAA values (P = 0.028) using a level of 15 mg/L on admission as reference value gave low sensitivity (55%) and predictive value (60%) for complications as well as low sensitivity for early prediction of fatal outcome (60%). The present study did not allow prediction of complications or mortality based on ACT or AGP values.

Haematological profile in healthy urban population (8 to 70 years of age).

Haematological profile for 17 constituents of blood were determined in 998 healthy school children (8-19 years old) and 2246 healthy adult persons (20-70 years old) residing permanently or at least 5 years in a defined geographic region of Zagreb, Croatia. Physiological variations corresponding to age and sex were studied as the most important factors affecting biological variation in haematological constituents of blood. In our study erythrocytes, haemoglobin and haematocrit values were not sex dependent until the age of 13 after which the values were higher in men that in women. Sedimentation rate showed sex and age related differences in the adult age with higher values in women especially after 50 years. Total leukocyte count declined with age and in adults the values were slightly lower in women. Segmented neutrophil granulocytes showed the upward trend with age whereas the lymphocyte and monocyte counts declined. Women showed slightly higher platelet count in the adult age. Based on biological variation, we have estimated the reference intervals for 17 haematological constituents of blood in order to provide medically reliable evaluation of haematological laboratory results.

Effect of medrogestone on conversions of pregnenolone and 17 alpha-hydroxypregnenolone in rat testis.

Medrogestone, viz., 6,17-dimethylpregn-4,6-diene,3,20-dione (Colprone), a synthetic compound with progestational and antiandrogenic properties, was studied for its effects on the metabolism of pregnenolone and 17 alpha-hydroxypregnenolone by a 10,000 g supernatant fraction of testicular homogenates. This compound inhibited the conversion of pregnenolone to progesterone (91%), 17 alpha-hydroxyprogesterone (83%), delta 4-androstenedione (43%), and testosterone (30%) and the conversion of 17 alpha-hydroxypregnenolone to 17 alpha-hydroxyprogesterone (84%), delta 4-androstenedione (56%), and testosterone (38%).

Inhibition of testosterone metabolism by medrogestone in rat ventral prostate in vivo and in vitro.

Medrogestone (MDG), viz., 6,17-dimethyl-4,6-pregnadiene-3,20-dione (Colprone), a synthetic compound with progestational and antiandrogenic properties was studied for its effect on the conversion of testosterone (T) to 5 alpha-dihydrotestosterone (DHT) and 5 alpha-androstane-3 alpha(beta)-17 beta-diol (Adiol) by ventral prostatic preparations of the rat. MDG, 20 mg/kg b.w./day s.c. for 14 days, inhibited the conversion of T to DHT by ventral prostatic homogenates and cytoplasm and at the same dose and route, but for 28 days, it reduced the conversion of T to DHT by ventral prostatic nuclei and T to Adiol by ventral prostatic cytoplasm and nuclei. MDG, from 1 X 10(-4) to 1 X 0(-5) M final concentration in vitro, induced dose-dependent decreases in the conversions of T to DHT and Adiol by ventral prostatic nuclei.

Catabolism of [4-14C]testosterone by subcellular fractions of human prostate.

1. Incubation conditions were established in experiments with human-prostate homogenates for almost complete conversion of [4-(14)C]testosterone into at least ten transformation products. 2. Whole homogenates of tissue with benign hypertrophy were shown to contain 3alpha-, 3beta- and 17beta-hydroxy steroid dehydrogenases, Delta(4)-3-oxo steroid 5alpha- and 5beta- reductases and unidentified hydroxylases. 3. Most of the 17beta-hydroxy steroid-dehydrogenase activity was located in the mitochondria, which showed little other activity. 4. The 3alpha- and 3beta-hydroxy steroid dehydrogenases and the 5beta-reductase were located in the high-speed supernatant and required supplementation with NADPH for activity. 5. The 5alpha-reductase was located in both microsomal and high-speed supernatant fractions and also required supplementation with NADPH.

Pediatric reference intervals for 34 biochemical analytes in urban school children and adolescents.

Concentrations of 34 biochemical constituents of sera were determined on 998 randomly selected urban school children and adolescents aged 8-18 years from Zagreb, Croatia. Reference intervals were obtained by using non-parametric methods to estimate 2.5 and 97.5 percentiles of distribution as upper and lower normal reference intervals, according to the IFCC recommendations. These were compared to reference intervals in the healthy adult population, aged 20-30 years from the same geographical area. Serum glucose, potassium, sodium, chloride, magnesium, iron, zinc, total serum proteins and electrophoretic fractions, and amylase, did not show age or sex differences; total serum bilirubin, total calcium, phosphate, high density lipoprotein cholesterol, total iron binding capacity, unsaturated iron binding capacity, copper, aspartate aminotransferase, alkaline phosphatase, cholinesterase, creatine kinase, and lactate dehydrogenase had higher reference intervals than the adult population. Urea, creatinine, urate, alanine aminotransferase, gamma-glutamyltransferase, total cholesterol and low density lipoprotein-cholesterol, and triglycerides had lower reference intervals than the adult population.